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Surgical Pearls | AAFPRS Annual Fall Meeting Featured Article

Reconstruction of the Nasoseptal L-Strut in Rhinoplasty

David W. Kim, MD1; Natalie H. Attenello, MD2
[+] Author Affiliations
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco
2Private Practice, Facial Plastic and Reconstructive Surgery, Los Angeles, California
JAMA Facial Plast Surg. 2015;17(6):457-458. doi:10.1001/jamafacial.2015.1522.
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This Surgical Pearl with video details the technique for reconstruction of the nasoseptal L-strut in rhinoplasty.

It is widely acknowledged that rhinoplasty is the one of the most difficult operations to perform. Margins are unforgiving, particularly in thin-skinned patients, because even the smallest of irregularities and asymmetries are prominently visible on a triangular pyramid that projects from the face. A smooth, symmetrical, well-proportioned surface contour is the ultimate aesthetic goal for rhinoplasty, and the multitude of available techniques are aimed to achieve this end. However, before the rhinoplasty surgeon can even begin to go to work to alter the osseous and cartilaginous structures that create this surface contour, he or she must establish a stable midline foundation on which the more superficial anatomical elements can be built. The L-strut septum functions as this foundation. The rhinoplasty surgeon must therefore be adept at modulation of the nasoseptal L-strut, including its reconstruction.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Reconstruction of the Septal L-Strut in Rhinoplasty

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